Prevention. Promotion. Protection.

Section Programs

Resources

Kids Don't Float PFD Loaner Program RENEWAL Form

Contact Person:

Sponsor Name:

Address (Include a Shipping Address for PFD's)

Work Phone:

Fax Number:

Email:

How Did You Hear About Us?

Comments:

 

Site Information

(Enter up to four sites.  Submit this form again to add more sites.)
Site: Description (Local Name) Site: (City/Town/Village) Site: Adding New or Renewal (only one can be selected) 

Site 1:


Adding New        
 Renewal

Site 2:


Adding New        
Renewal

Site 3:


Adding New        
Renewal

Site 4:


Adding New        
Renewal

 

Number of PFD Sets:

(One set includes 2 infant, 4 child, 4 youth, 3 adult and 1 X-Large adult PFDs)

 

-OR-

 

Order by size:

Number of KDF Signs:

The sign is a 2 x 4 foot adhesive decal

 
Additional Comments:

THANKS for promoting Kids Don't Float and making it a viable program in your community. Kids Don't Float is a statewide effort to reduce unintentional injury and drowning supported by the Alaska Department of Health and Social Services, the 17th Coast Guard District, the Alaska Boating Safety Program, and Alaska Safe Kids.

Click the "Send" button to submit information to the Kids Don't Float Office! Send email that pops up - or call Kids Don't Float if you have any difficulties submitting this form: (907) 465-4170